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Background and Importance In a rapidly evolving therapeutic landscape marked by the rise of next-generation immunotherapies, our university hospital is involved as a sponsor of clinical trials on both CAR-T cell therapies and bispecific antibodies (BsAbs), actively contributing to the development and evaluation of these innovations for the benefit of patients. Both BsAbs and CAR-T cells can trigger CRS through T-cell activation, but comparative data remain scarce. CRS results from massive immune activation following CAR-T cell infusion, leading to excessive release of cytokines, particularly interleukin-6 (IL-6). This inflammatory reaction can rapidly progress to severe multiorgan failure, requiring urgent treatment.Aim and Objectives To assess frequency, timing, and management of CRS associated with BsAbs versus CAR-T therapy in clinical trials at our centre.Material and Methods All adults receiving investigational BsAbs or CAR-T cells from January 2018 to July 2025 were retrospectively analysed. CRS episodes were graded using ASTCT criteria; therapeutic treatment, grade and outcomes were collected.Results A total of 91 patients were included: 51 received BsAbs and 40 received CAR-T therapy. CRS occurred in 9/51 (17.6%) BsAb patients and 20/40 (50%) CAR-T patients. Mean onset was earlier for BsAbs (25.7 h vs 112.2 h). Most events were grade 1–2 (BsAbs: 100% [grade 1: 22.2%; grade 2: 77.8%]; CAR-T: 90% [grade 1: 65%; grade 2: 25%]). Tocilizumab was used less frequently for BsAb-related CRS (77.8% vs 100%). Corticosteroid use was low in both groups. Resolution was achieved in all cases.Conclusion and Relevance CRS was more frequent with CAR-T cells than with BsAbs in clinical trials, but onset occurred earlier with BsAbs. The CRS grade appeared to be more severe with BsAbs.Conflict of Interest No conflict of interest